HROMADKA, Milan, Zuzana MOTOVSKA, Ota HLINOMAZ, Petr KALA, Ivo VARVAROVSKY, Jaroslav DUSEK, Michal SVOBODA, Jiří JARKOVSKÝ, Frantisek TOUSEK, Pavel JANSKY, Stanislav SIMEK, Marian BRANNY, Jan MROZEK, Roman MIKLÍK, Richard ROKYTA and Petr WIDIMSKY. The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study. JOURNAL OF CARDIOLOGY. NETHERLANDS: ELSEVIER, 2022, vol. 79, No 5, p. 1-8. ISSN 0914-5087. Available from: https://dx.doi.org/10.1016/j.jjcc.2021.11.015.
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Basic information
Original name The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study
Authors HROMADKA, Milan (203 Czech Republic), Zuzana MOTOVSKA (203 Czech Republic, guarantor), Ota HLINOMAZ (203 Czech Republic, belonging to the institution), Petr KALA (203 Czech Republic, belonging to the institution), Ivo VARVAROVSKY (203 Czech Republic), Jaroslav DUSEK (203 Czech Republic), Michal SVOBODA (203 Czech Republic, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Frantisek TOUSEK (203 Czech Republic), Pavel JANSKY (203 Czech Republic), Stanislav SIMEK (203 Czech Republic), Marian BRANNY (203 Czech Republic), Jan MROZEK (203 Czech Republic), Roman MIKLÍK (203 Czech Republic, belonging to the institution), Richard ROKYTA (203 Czech Republic) and Petr WIDIMSKY (203 Czech Republic).
Edition JOURNAL OF CARDIOLOGY, NETHERLANDS, ELSEVIER, 2022, 0914-5087.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher Netherlands
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 2.500
RIV identification code RIV/00216224:14110/22:00128074
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.jjcc.2021.11.015
UT WoS 000821518300009
Keywords in English Acute myocardial infarction; Symptoms onset to needle time; Risk stratification; P2Y12 inhibitors; Ischemic endpoints
Tags 14110115, 14110211, 14119612, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 24/7/2023 12:57.
Abstract
Objectives: Based on previous studies with clopidogrel, the time between acute myocardial infarction (AMI) symptoms onset and primary percutaneous coronary intervention (PCI) was proven as important prognostic factor. Our aim was to assess the relationship between symptoms onset to needle time (SNT) and procedural results and the occurrence of ischemic endpoints in primary angioplasty patients treated with potent P2Y12 inhibitors. Methods: A total of 1,131 out of 1,230 patients randomized to the Prague-18 study (prasugrel vs. ticagrelor in primary PCI) were divided into a high and a low-risk group. The effect of defined SNT on patients' ischemic endpoints and prognosis by their risk status at admission was tested. Results: The median SNT was 3.2 hours. Longer SNTs resulted in a more frequent incidence of TIMI flow <3 post PCI (p=0.015). There were significant differences in the occurrence of the combined ischemic endpoint among the compared SNT groups at 30 days (p=0.032), and 1 year (p=0.011), with the highest incidence in the <<= 1 h SNT group of patients. "Latecomers" (SNT>4 hs) in the high-risk group experienced more reinfarction within 1 year [OR (95% CI) 3.23 (1.09-9.62) p=0.035]; no difference was found in the low-risk group. Conclusions: In the era of intense antithrombotic medication, stratification of MI patients undergoing primary angioplasty, based on initial ischemic risk assessment affected prognosis more than symptom onset to needle time. Longer time delay was significantly related to increased incidence of ischemic events and all-cause mortality only in patients with high ischemic risk. (C) 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
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